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13020101 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10600 RANDY IN CONTRACTOR:Mari a.36,n PERMIT NO: 13020101 C'FG✓PY t S� OWNER'S NAME: ANDREWS WILLIAM AND MARY TRUST DATE ISSUED:02/19/2013 OWNER'S PHONE: 4082524044 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIALU COMMERCIAL License Class Lic.# ?3 , TEAR OFF(E)WOOD SHAKE,INSTALL NEW LANDMARK 40 Contractorfl7o VOG/[� �J✓�C TDWI)ateRa, >�� YR CLASS COMP ON HOME(24 SQ'S)&DETACHED I hereby affirm that I am licensed under the provisions of Chapter 9 GARAGE (commencing with Section 7000)of Division 3 of the Business&Professions (8 SQ'S) Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 1 have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$12800 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:31602063.00 Occupancy e: permit is issued. P y TyP APPLICANT CERTIFICATION I certify,that have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.7 agree to comply with all city and county ordinances and state laws relatingW PI HIN 180 DAYS T ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter _ upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FR CALLED INSPECTION. indemnify and keepharmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply I Date: with all non-point source regulations per the Cupe ' o Municipal Code,Section 9.18. RE-ROOFS: Signator All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION. Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: - ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE concoct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. - will maintain compliance with the Cupertino Munici id Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 74505, 533, 5534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agepf• Daf; '/9' permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. I;after making this certificate of exemption,1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 1 certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may amme against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature - Date - REROOF PERMIT APPLICATION COMMUNITY gEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 950143255 O (408)7773228•FAX(408)777-3333•buildinafwaertino.ora CUPERTINO "'79f,71) RoDBEs iQLA NE., G a-44 M' APNO n eHorae ESA° - S'[RE£I•: ll �� . CITY.SUltti FAX CONTACL NAArr..��E l PEIWrG '1 Q g�20 vs�� �•�• STAFfT ADDRESS CITY.STALE,ZIP FAX sete Q o OjIwA ❑ owNFR•Enam ❑owNEEAGBrf ❑ commem 1coNnthaoRmwir ❑ &Uml l.T ❑F1++cam ❑ Devaom ❑Taw;r CONTRA OR NAalE LICENSE NtM6FRl�/I,/ UCENSETYPE I�1 BUS.uc.a i� rz - m0,,1 r 77 L� (yam / / COSwANYN QIS (� pM, I r.171'Y1CAS a/LP. F N 61l pl sTREET. .Sf $ �, �7°"7S5 d tn/ .1 _._. _. .1,5'._ .p-. ->�130 PH p 9 � d ARCHfrECTiENGmFFANAME 110ENSENUM&L �_ BUS.LIC.a COIAPANYNMm E.MAR. FAX STREET ADDRESS CrrY.STATE,ZIP PHONE -- VSE OF Iq SFD OT Duplexd MUIQmi7}: -Fa0.00F.4 VALVA&/,p STRUCHIRE: ❑ Commercial 2-9 EXtSRNGROOFryPF-q ❑BUILT-UPROOF ❑ASPHALTSF@tmD FS AwooSNARES ❑womsHINGIES ❑ PECffY) orjmts R U)VE(REPLACE LYES IF NO. PLYwoor, ❑e" ❑ PLYWD aff.OSBPITCH: y� :ll ROOF A ❑ ! ❑ ❑Cox tccEs RFroRr a PROPosmltooFTYPE: ❑BUILT-tIPmoF dASPHALTsHm m El WOOD sHAm ❑woonsiumo s ❑OTID1t DESCRIPUON OF WO — K,>J / D 1J Co /O tilt/ elf/wry A By my signature below,l certify ooeschofthefollowhig: lam the poperyown .Orautlariud agent to act on the property ownds behalC Ihave readthis application and the infon ation 1 have tded a Correa I have rote aiption ofwodr ad verfy it is aocutat, I agree to comply with all applicable local ordinances and state laws mice' to i 1 eutho tatives Gr='o to enter the aabove4denn pro�pj(a�)f)or inspection purposes. SignatureofApplicantlAg SUPPLEMENTALINFOEUATION nTJIRED 0FPr�nseoncv _If building is associated with a Home Owne's Association,provide letter "AN CHECK '>!rE :RotrnNc SLIP, . t of approval from HOA. Vern-m-c oumm ❑ BURMING PUN REVIEW Provide Planning approval to verify if dwm any restrictions. ❑ EXPRESS ❑ PUNNING PLAN REVIEW Provide copy of Manufacturees installation Specifications. ❑ S mmm ❑ FIRE DEPT Provide signed copy of Oupertinds Tear-OffPolicy. ❑ OTHER- . ReroofApp_201I-doe revised 03/16111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10600 RANDY LN DATE: 02/19/2013 REVIEWED BY: MELISSA APN: 316 02 063 BP#: 'VALUATION: $12,800 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1SFDWLR0OF USE: PERMIT TYPE: WORK TEAR OFF E WOOD SHAKE INSTALL NEW LANDMARK 40 YR CLASS COMP ON HOME 24 SCOPE SQ'S) & DETACHED GARAGE (8 SQ'S) } tx vww s r rt{°i3�'r �I 5 r h r3Ndt�! Y s..�i.°.{.C.i1�IL'��'.. '� � n��� R?1': �r'�•3L�.4?� r�RYa�(A'�3 Curr-. Xlech. Plan Check Plumb.Plan Check Elea.Plan Check h ch, P rnril Fee: Plumb.Permit Fee: lilec.Peonit Fe. Other bfech, Insp. Other Plumb Insp. Li I O/her Elec.Insp. Li :Meeh Insp. Fee.: Plumb.Insp. Pee: Elec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District etc). These fees are based on the prelimina in ormadon available and are only an estimate. Contact the Dept)*addn'l info. FEE ITEMS Fee Resolution 11-053 E . 7111121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F3 260 s.£ Re roof Suppl.PC Fee: 0 Reg, 0 OT 0.0 hrs $0.00 $480.00 IREROOFREs PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tac Administrative Fee: O Work Without Permit? O Yes 0 No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Trove.[Documentation Fees: Building or Structure O Strong Motion Fee: 1BSEISMICR $1.28 Select an Administrative Item. _ Bldg Stds Commission Fee: 1BCBSC $1.00 $2.281 $480.00 ['", TO��1LtTE.E $482.28 M Revised: 01/01/2013 Z1 � t REROOF TEAR-OFF'POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION MLBERT SALVADOR,F.E.C.B.O.,BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C V PERTINO (406)777_3228.FAx(408)777-3333•buildin°iIDwcertlno.or° APNv ° qR o�r2PlJ�S o �Z- o 5�>udr'. Co STREEI'AD� N� CRY,srATE,Z@ �- JO� FAX CO R 14 O i. ' >1C6�ENUAfBER �f UCE SETYPE I? BUS.UC.A CO r,vF✓t/� SES �"B'or1 a 9 4�Gv,ujs, 76� "°�'mm oc- a49 I zo S�6& - 96/3o 4 ie- 6 6p I UNDERSTAND-AND AGREE TO THE FOLLOWING: I. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please call(408)777-3229 from 7.30-3:30pm(MonrThurs)or 730-230pm(Friday)to schedule inspection. For Tear-Off and Nailing Inspections,you must also call on the day of the inspection only after that phase of thewarkis complete(L The building inspector will be available within one hour. Final Inspections will be given a two hour window. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof Aheathing is pioop©sed throughout,all the nails/fasteners shall be either completely knocked-down or removed prior to this inspection. 4. If plywood is installed,a plywood Nailing inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector- Any mofiug wbM is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. A Final Inspectim and approval shall be obtained from the building inspector when the re-roofing is completed. To receive a final sign-off,the following items will be verified: a. Flat'roofs shall have minimum of'k"per foot of slope and demonstrate there is no ponding. b. Listings frormapproved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. , c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. 7. NOTE: if you call for a tear-offor plywood trailing inspection and the work is not complete,you will be charged a re-inspection fee. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below,I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide detectors are required to be installed in accordance with Sections 8314 and P 315 of the 2010 California Residential Code. Signature ofA piicanUAgent: Date: RerooJPoliey_IDJ?.dvc revised/A?/12 Building Department _ City Of Cupertino 10300 Tone Avenue Cupertino,CA 95014-3255 CUPERTINO „:Telephone:408 -777-3228 Fax:408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST..1 JOB ADDRESS:10600 . ,Dy Z.A O PERMIT# OWNER'S NAME: h2 -f PHONE# ' GENERAL CONTRACT X) ).ice BUSINESS..LICENSE# ADDRESS:q-5-7) CITY/ZIPCODE a )3O *Our municipal code requires all busine es working in the city to have,*, City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCBEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS .HAVFr_OBTAINED A•CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following informations; SUBCONTRACTOR BUSINESS NAME ;,BUSINESS LICENSE# Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry VV Painting/Wallpaper Paving Plastering Plumbing X ` 1>C Roofing Septic Tank Sheet Metal Sheet Rock Tile 9 �» (/Owner/C&' actor Signature Date